ArticleJournal of epidemiology and global health2023
Incidence and Determinants of Symptomatic and Asymptomatic SARS-CoV-2 Breakthrough Infections After Booster Dose in a Large European Multicentric Cohort of Health Workers-ORCHESTRA Project.
Article in Journal of epidemiology and global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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23 citing papers in PubMed, 26 citations in OpenAlex.
- What shapes influenza attitudes and behaviors in Italy? Insights from a cross-sectional study.Human vaccines & immunotherapeutics · 2026Article
- Impact of Occupational and Extra-Professional Exposure Across the Different Waves of the Pandemic on the Risk of SARS-CoV-2 Infection Among Healthcare Workers-The ORCHESTRA Project.Healthcare (Basel, Switzerland) · 2026Article
- The role of hospitals in monitoring the emergency: the experience of "Sentinel network" of the Italian Federation of Health Trusts.BMC health services research · 2026Article
- COVID-19 vaccination remains essential for healthcare professionals: clinical evidence from a Polish cross-sectional study.Frontiers in public health · 2026Article
- Italian healthcare professionals' real-world experience with immunization in children of non-European origin: the Vax4globe survey.Frontiers in pediatrics · 2026Article
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- Risk factors for infection with SARS-CoV-2 in a cohort of Canadian healthcare workers: 2020-2023.Epidemiology and infection · 2025Article
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- COVID-19 severity and risk of SARS-CoV-2-associated asthma exacerbation by time since booster vaccination: a longitudinal analysis of data from the COVIDENCE UK study.BMJ open respiratory research · 2025Observational
- SARS-CoV-2 Vaccines and Multiple Sclerosis: An Update.Neurology(R) neuroimmunology & neuroinflammation · 2025Review
- Influenza Vaccine Effectiveness Against Illness and Asymptomatic Infection in 2022-2023: A Prospective Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Occupation: a predisposing factor for SARS-CoV-2 infection among hospital employees? A single-centre retrospective cohort study conducted in Austria.BMJ public health · 2025Article
- Comparison of SARS-CoV-2 IgG responses in hemodialysis patients and healthcare workers after COVID-19 vaccination.Frontiers in immunology · 2025Article
- Long-term effectiveness of an ultra-rapid rollout vaccination campaign with BNT162b2 on the incidence of SARS-CoV-2 infection.iScience · 2024Article
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- Hybrid Immunity and the Incidence of SARS-CoV-2 Reinfections during the Omicron Era in Frontline Healthcare Workers.Vaccines · 2024Article
- Editorial: Knowledge, attitudes and perceptions of healthcare professionals and health professions students towards vaccinations and non-pharmaceutical interventions.Frontiers in medicine · 2024Article
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Authors and funding
33 authors at 16 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSARS-CoV-2 breakthrough infections (BI) after vaccine booster dose are a relevant public health issue.
methodsMulticentric longitudinal cohort study within the ORCHESTRA project, involving 63,516 health workers (HW) from 14 European settings. The study investigated the cumulative incidence of SARS-CoV-2 BI after booster dose and its correlation with age, sex, job title, previous infection, and time since third dose.
results13,093 (20.6%) BI were observed. The cumulative incidence of BI was higher in women and in HW aged < 50 years, but nearly halved after 60 years. Nurses experienced the highest BI incidence, and administrative staff experienced the lowest. The BI incidence was higher in immunosuppressed HW (28.6%) vs others (24.9%). When controlling for gender, age, job title and infection before booster, heterologous vaccination reduced BI incidence with respect to the BNT162b2 mRNA vaccine [Odds Ratio (OR) 0.69, 95% CI 0.63-0.76]. Previous infection protected against asymptomatic infection [Relative Risk Ratio (RRR) of recent infection vs no infection 0.53, 95% CI 0.23-1.20] and even more against symptomatic infections [RRR 0.11, 95% CI 0.05-0.25]. Symptomatic infections increased from 70.5% in HW receiving the booster dose since < 64 days to 86.2% when time elapsed was > 130 days.
conclusionsThe risk of BI after booster is significantly reduced by previous infection, heterologous vaccination, and older ages. Immunosuppression is relevant for increased BI incidence. Time elapsed from booster affects BI severity, confirming the public health usefulness of booster. Further research should focus on BI trend after 4th dose and its relationship with time variables across the epidemics.
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